Trainee Assessment & Competency. Dr Adam Haycock

Transcription

1 Trainee Assessment & Competency Dr Adam Haycock PET Rome September 2017

2 Contents Skills acquisition Competency vs expertise When to use assessments Types of assessments Assessment tools Numbers and key performance indicators

3 performance Skills acquisition Expertise Competence time

4 performance Skills acquisition Expertise Safely perform independently Competence time

5 performance Skills acquisition Expertise Safely perform independently Competence Minimum standard? time

6 performance Skills acquisition Expertise Average? Safely perform independently Competence Minimum standard? time

7 performance Skills acquisition To do it on you? Expertise Average? Safely perform independently Competence Minimum standard? time

8 performance Skills acquisition Expertise Competence time

9 Skills acquisition Ward ST, et al. Gut 2014;63:

10 performance Skills acquisition Expertise intubation therapy Competence detection time

11 Skills measurement Direct Measure Surrogate Measure Intubation Detection Therapy

12 Skills measurement Direct Measure Surrogate Measure Intubation Detection Therapy Pain PCCRC Perforation PCCRC Sedation levels CIR PDR ADR Polyp retrieval rate Completeness of excision

13 Skills measurement Direct Measure Surrogate Measure Intubation Detection Therapy Pain PCCRC Perforation PCCRC Sedation levels CIR PDR ADR Polyp retrieval rate Completeness of excision

14 Skills measurement Direct Measure Surrogate Measure Intubation Detection Therapy Pain PCCRC Perforation PCCRC Sedation levels CIR PDR ADR Polyp retrieval rate Completeness of excision

15 Skills measurement Direct Measure Surrogate Measure Intubation Detection Therapy Pain PCCRC Perforation PCCRC Sedation levels CIR PDR ADR Polyp retrieval rate Completeness of excision

16 performance Skills acquisition Expertise KPI KPI KPI KPI? Competence time

17 DOPS Directly Observed Procedure Score

18 Scope handling DOPS Exhibits good control of head and shaft of colonoscope at all times Angulation controls manipulated using the left hand during the procedure Demonstrates ability to use all scope functions (buttons/biopsy channel) whilst maintaining stable hold on colonoscope Minimises external looping in shaft of instrument Tip control Integrated technique: Combines tip and torque steering to accurately control the tip of colonoscope and manoeuvre the tip in the correct direction. Individual components: Tip steering: Avoids unnecessary mucosal contact and maintains luminal view, avoiding need for blind negotiation of flexures and 'slide-by' where possible Torque steering: Demonstrates controlled torque steering using right hand/fingers to rotate shaft of colonoscope Luminal awareness: Correctly identifies luminal direction using all available visual clues, and avoids red outs

19 performance Skills acquisition Expertise DOPS KPI KPI KPI KPI Competence DOPS DOPS DOPS DOPS time

20 performance Skills acquisition Expertise intubation KPI KPI KPI KPI Competence detection time

21 performance Skills acquisition Expertise intubation therapy Competence detection time

22 performance Skills acquisition Expertise intubation therapy DOPyS Competence detection DOPyS DOPyS time DOPyS

23 DOPyS 33 criteria Skills Live Video Assessment/ pre-polypectomy Stalked polyps Sessile polyps/emr Post-polypectomy

24 Technical vs non-technical skills Cognitive Knowledge Psychomotor Skills Affective Attitudes Bloom B. S. (1956). Taxonomy of Educational Objectives, Handbook I: The cognitive domain.

25 Endoscopic Non-Technical Skills (ENTS)

26 Assessment tools MCSAT - colon ACE OGD, colon GAGES OGD, colon GiECATKIDS paeds colon DOPS- OGD, colon/flexi, ERCP, EUS, PEG, GI bleeds, dilatation/stenting, paediatrics, polypectomy

27 Summary Competency is contextual Assessment formative vs summative DOPS during training, KPI's when independent Multifactorial Knowledge, Skills, Attitudes